Brain SPECT imaging and treatment with IVIg in acute post-infectious cerebellar ataxia: case report.
A 19 year-old man presented with pharyngitis and cervical lymphadenopathy, followed by vomiting and acute cerebellar ataxia. Serologic studies were consistent with a recent Epstein-Barr virus infection. Although contrast-enhanced brain computed tomography and MRI scans were normal, brain perfusion single photon emission tomography (SPECT) examination using 99mTc-HMPAO, performed on the 15th day of illness, showed marked cerebellar hyperperfusion, suggesting a diagnosis of acute post-infectious cerebellitis. After treatment with intravenous human immunoglobulin (IVIg, 2 g kg-1 over three days), progressive neurologic improvement occurred over two weeks. A brain SPECT study repeated after two additional weeks demonstrated a normal perfusion pattern. We conclude that brain perfusion SPECT examination is useful in identifying post-infectious cerebellitis and in monitoring its clinical course. In addition, IVIg may be helpful in treating this condition.
Daaboul
Y
Y
Department of Neurology, University of Illinois at Chicago 60612, USA.
Vern
B A
BA
Blend
M J
MJ
D000328:Adult; D002524:Cerebellar Ataxia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D002560:Cerebrovascular Circulation; D018792:Encephalitis, Viral / Q000150:complications; D004854:Herpesvirus 4, Human; D006801:Humans; D016756:Immunoglobulins, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D016756:Immunoglobulins, Intravenous; D019690:Technetium Tc 99m Exametazime